Individual
JACLYN SUZANNE POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2002 12TH AVE NW STE C, ARDMORE, OK 73401-1206
(405) 715-3610
Mailing address
PO BOX 268988, OKLAHOMA CITY, OK 73126-8988
(405) 715-3610
(405) 715-3612
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0089907
OK
Other
Enumeration date
09/28/2011
Last updated
07/21/2022
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